Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,786.30 / $6,760.83 / $11,220.18	Facility		$4,786.30	$6,760.83	$11,220.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,786.30 / $4,786.30 / $6,165.95	Professional		$4,786.30	$4,786.30	$6,165.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,786.30 / $4,786.30 / $5,011.87	Facility		$4,786.30	$4,786.30	$5,011.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,786.30 / $4,786.30 / $4,786.30	Professional		$4,786.30	$4,786.30	$4,786.30
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $4,073.80 / $4,073.80 / $4,265.80	Facility		$4,073.80	$4,073.80	$4,265.80
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $4,073.80 / $4,073.80 / $4,073.80	Professional		$4,073.80	$4,073.80	$4,073.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $4,466.84 / $7,079.46	Facility		$4,265.80	$4,466.84	$7,079.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,786.30 / $4,786.30 / $19,952.62	Professional		$4,786.30	$4,786.30	$19,952.62
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $4,570.88 / $5,888.44 / $16,218.10	Facility		$4,570.88	$5,888.44	$16,218.10
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $5,248.07 / $5,248.07 / $6,025.60	Professional		$5,248.07	$5,248.07	$6,025.60
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,677.35 / $4,677.35 / $4,897.79	Facility		$4,677.35	$4,677.35	$4,897.79
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,677.35 / $4,677.35 / $4,897.79	Professional		$4,677.35	$4,677.35	$4,897.79
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $6,025.60 / $50,118.72 / $75,857.76	Facility		$6,025.60	$50,118.72	$75,857.76
United Facility/Professional Facility Modifier Low / Median / High Price $4,786.30 / $4,786.30 / $4,786.30	Facility		$4,786.30	$4,786.30	$4,786.30
United Facility/Professional Professional Modifier Low / Median / High Price $4,677.35 / $4,786.30 / $7,079.46	Professional		$4,677.35	$4,786.30	$7,079.46
Univera Facility/Professional Facility Modifier Low / Median / High Price $4,677.35 / $4,677.35 / $5,495.41	Facility		$4,677.35	$4,677.35	$5,495.41
Univera Facility/Professional Professional Modifier Low / Median / High Price $2,344.23 / $4,677.35 / $5,623.41	Professional		$2,344.23	$4,677.35	$5,623.41